A mixed-method evaluation of Cradle to Kinder : an Australian intensive home visitation program for families experiencing significant disadvantage

Cradle to Kinder is an Australian intensive, long-term, home visitation program that supports young families experiencing multiple stressors, including poverty, family violence, mental illness, substance use, childhood trauma, intellectual disability, child projection involvement, teenage pregnancy, or social isolation, which places them at high risk of child removal. The program adopts a multidisciplinary, whole-of-family and trauma-informed approach to provide families with long-term case management, practical support and evidence-based therapeutic parenting interventions from pregnancy for up to four years to address these underlying risk factors. The aim of this study was to evaluate: (1) the extent to which families experienced improvements in family, caregiver and infant wellbeing outcomes after 24 months engagement; and (2) caregivers’ experiences of the program. A mixed-method evaluation was employed, which included two components: (1) uncontrolled pre-post quantitative assessment for 57 families using the North Carolina Family Assessment Scale and Brigance Early Child Development Assessment, completed every six months; and (2) qualitative interviews with 14 caregivers engaged in the program. The quantitative findings showed significant improvements in key domains of family functioning, parenting capabilities, infant development, and family preservation. The qualitative results validated these findings as caregivers reported favourable outcomes via participation in the program, including improved parenting skills and confidence, personal wellbeing, and child development. Suggestions for program development included greater support for fathers, increased cultural awareness, and consistency in workers. This mixed-methods study provides support for Cradle to Kinder as a promising model of family support that can improve family functioning, caregiver and child wellbeing, and prevent child removal among families experiencing significant disadvantage. These findings support the ongoing delivery of Cradle to Kinder in Australia to ensure families at greatest risk receive the support they urgently need

Interventions and practice models for improving health and psychosocial outcomes of children and young people in out-of-home care:protocol for a systematic review

Introduction: Children and young people placed in out-of-home care (OoHC) are often affected by a history of trauma and adverse childhood experiences. Trauma in early childhood can impact on children’s health and psychosocial development, whereas early interventions can improve children’s development and placement stability. Although several interventions and practice models have been developed to improve health and psychosocial outcomes for children and young people in OoHC, there remains a lack of rigorous research examining the impact of these interventions in OoHC settings, as there are no systematic reviews examining the impact these interventions and practice models have on the children and young people they serve. We aim to conduct a comprehensive systematic review to examine the effectiveness of interventions and practice models for improving health and psychosocial outcomes in children and young people living in OoHC and to identify relevant knowledge gaps. Methods and analysis: Major electronic databases including Medline, Medline in-process and other non-indexed citations, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Sociological Abstracts and all Evidence-Based Medicine Reviews incorporating: Cochrane Database of Systematic Reviews, American College of PhysiciansJournal Club, Database of Abstracts of Reviews of Effects,Cochrane Central Register of Controlled Trials, CochraneMethodology Register, Health Technology Assessment and National Health Service Economic Evaluation Database, will be systematically searched for any studies published between 2008 and 2018 of interventions and practice models developed to improve health and psychosocial outcomes for children and young people in OoHC. Two independent reviewers will assess titles and abstracts for eligibility according to prespecified selection criteria and will perform data extraction and quality appraisal. Meta-analyses and/or metaregression will be conducted where appropriate. Ethics and dissemination: This study will not collect primary data and formal ethical approval is therefore not required. Findings from this systematic review will be disseminated in a peer-reviewed publication and conference presentations. PROSPERO registration number: CRD42019115082

Interventions and practice models for improving health and psychosocial outcomes for children in residential out-of-home care : systematic review

Young people in residential out-of-home care often exhibit health and psychosocial challenges, which can emerge from childhood trauma. A body of research has examined the wellbeing of these young people; however, the ways in which interventions and practice models can improve the health and psychosocial wellbeing of young people in out-of-home care remains unclear. A systematic review was conducted to examine the effectiveness of interventions and practice models for improving health and psychosocial outcomes of young people in residential care and to identify relevant knowledge gaps. After a worldwide search, only four studies, from Australia (n = 2), USA (n = 1), and Canada (n = 1) were found. These studies evaluated Cognitive Behaviour Treatment, Healthy Eating Active Living, Power Through Choices and the Alternate Care Clinic. These studies aimed to improve numerous health and psychosocial outcomes including mental health, behaviour, obesity, pregnancy and sex. Despite limited evidence, the review suggests that contemporary interventions and practice models do have the potential to have positive impacts on the health and psychosocial outcomes of young people in residential care. Rigorous assessment of promising evidence-based interventions is urgently needed to advance best practice and improve outcomes. IMPLICATIONS Therapeutic and psychosocial approaches have significant impacts on the health and psychosocial wellbeing of young people in residential out-of-home care. Interventions and practice models within residential out-of-home care should incorporate trauma-informed care and psychoeducation. Findings from this review may guide the design and implementation of interventions and practice models in out-of-home care as well highlighting knowledge gaps for future research in this field

Residential out-of-home care staff perceptions of implementing a trauma-informed approach : the sanctuary model

The aim of this study was to explore and better understand the enablers and barriers of implementation and how these impact on the organisational successes and challenges of adopting The Sanctuary Model, as perceived by residential care staff. Following ethics approval, three semi-structured interviews and six focus groups were conducted with residential care staff between February and July, 2020. Participants identified a number of enablers, presented in the subthemes: (a) social support systems and resources; (b) shared trauma-informed knowledge and understanding; and (c) leadership and champions. These enablers influenced organisational successes in adopting: (a) the Sanctuary Commitments; (b) the S.E.L.F Framework; (c) Reflective Practice and Supervision; and (d) Trauma Theory. A number of barriers hindering implementation were identified. These were reflected in the subthemes: (a) informal practice; (b) lack of practice-based training; (c) poor introduction to young people; and (d) resources. These barriers impacted on organisational challenges faced in residential out-of-home care including: (a) The Sanctuary Model Toolkit and (b) young people's behaviour and engagement. Comparisons from this study and previous findings identified by executive and upper management staff (decision makers) are discussed. Key findings indicate that when implementing, sustaining and embedding The Sanctuary Model, organisations need to become trauma-informed rather than 'do' trauma-informed care and organisations need to "live and breathe" The Sanctuary Model Commitments, be connected and inclusive of one another, use trauma-informed language and feel safe. [Abstract copyright: © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021.

MacKillop Family Services’ Family Preservation and Reunification Response for Vulnerable Families—Protocol for an Effectiveness-Implementation Study

International evidence supports the effect of intensive family preservation and reunification services in preventing children’s placement in out-of-home care (OOHC). Evidence within Australia is scarce. This protocol paper describes a hybrid effectiveness-implementation evaluation of the Victorian Family Preservation and Reunification (FPR) Response implemented by MacKillop Family Services. Participants include families engaged in the program and staff involved in program delivery. A pre-post study design will be used to assess the effectiveness of the FPR in improving family outcomes from intake to closure, including: (i) parenting knowledge, skills, and capability; (ii) family safety and home environment; (iii) child development, adolescent behaviour, education attendance and attachment; (iv) connection to services; and (v) prevention of children from entering or re-entering OOHC. Interviews and focus groups will be conducted with staff to evaluate the program’s fidelity, reach, feasibility, acceptability, and enablers and barriers to implementation. Quantitative data will be analysed using descriptive statistics and a series of paired-samples t-tests and F tests to examine changes in outcomes over time; thematic analysis will be used for qualitative data. If the FPR can yield significant improvements in families’ outcomes, this would provide strong support for its scale-up across Australia, to better support vulnerable families

‘All Aboriginal and Torres Strait Islander children should have access to the ASQ‐TRAK ’ : shared vision of an implementation support model for the ASQ‐TRAK developmental screener

Issue Addressed The ASQ-TRAK, a strengths-based approach to developmental screening, has high acceptability and utility across varied Aboriginal and Torres Strait Islander contexts. While substantive knowledge translation has seen many services utilise ASQ-TRAK, we now need to move beyond distribution and support evidence-based scale-up to ensure access. Through a co-design approach, we aimed to (1) understand community partners' perspectives of barriers and enablers to ASQ-TRAK implementation and (2) develop an ASQ-TRAK implementation support model to inform scale-up. Methods The co-design process had four phases: (i) partnership development with five community partners (two Aboriginal Community Controlled Organisations); (ii) workshop planning and recruitment; (iii) co-design workshops; and (iv) analysis, draft model and feedback workshops. Results Seven co-design meetings and two feedback workshops with 41 stakeholders (17 were Aboriginal and Torres Strait Islander), identified seven key barriers and enablers, and a shared vision – all Aboriginal and Torres Strait Islander children and their families have access to the ASQ-TRAK. Implementation support model components agreed on were: (i) ASQ-TRAK training, (ii) ASQ-TRAK support, (iii) local implementation support, (iv) engagement and communications, (v) continuous quality improvement and (vi) coordination and partnerships. Conclusions This implementation support model can inform ongoing processes necessary for sustainable ASQ-TRAK implementation nationally. This will transform the way services provide developmental care to Aboriginal and Torres Strait Islander children, ensuring access to high quality, culturally safe developmental care

Textural changes of graphitic carbon by tectonic and hydrothermal processes in an active plate boundary fault zone, Alpine Fault, New Zealand

Graphitization in fault zones is associated both with fault weakening and orogenic gold mineralization. We examine processes of graphitic carbon emplacement and deformation in the active Alpine Fault Zone, New Zealand by analysing samples obtained from Deep Fault Drilling Project (DFDP) boreholes. Optical and scanning electron microscopy reveal a microtextural record of graphite mobilization as a function of temperature and ductile then brittle shear strain. Raman spectroscopy allowed interpretation of the degree of graphite crystallinity, which reflects both thermal and mechanical processes. In the amphibolite-facies Alpine Schist, highly crystalline graphite, indicating peak metamorphic temperatures up to 640°C, occurs mainly on grain boundaries within quartzo-feldspathic domains. The subsequent mylonitization process resulted in the reworking of graphite under lower temperature conditions (500–600°C), resulting in clustered (in protomylonites) and foliation-aligned graphite (in mylonites). In cataclasites, derived from the mylonitized schists, graphite is most abundant (<50% as opposed to <10% elsewhere), and has two different habits: inherited mylonitic graphite and less mature patches of potentially hydrothermal graphitic carbon. Tectonic–hydrothermal fluid flow was probably important in graphite deposition throughout the examined rock sequences. The increasing abundance of graphite towards the fault zone core may be a significant source of strain localization, allowing fault weakening